One of the scariest things in the world is to lose your health, it gets worse if it is someone you love who needs medical attention. The post will inform about realities what to expect and empower you to avoid financial disasters, dealing with American Healthcare.
U.S. Healthcare is a
$4 Trillion dollar business
First, lets set the stage by learning the facts:
- Healthcare system is a for-profit business enterprise, with a goal to produce revenue
- There are 6,146 hospitals, 1.1 million doctors and countless other healthcare professionals
- Hundreds of pharmaceutical, diagnostics, and other suppliers (Credit: org)
- In 2018 U.S. Healthcare spending reached $3.65 trillion dollars, surpassing Brazil, and the United Kingdom entire economy GDP (Credit: Axios)
- Overall healthcare costs are rising faster than the nations economy and income levels, which means patients will need to contribute more to close the gap
- In 2018, average healthcare spending reached approximately $11,121 per person in the U.S.
- 59% of all healthcare costs were attributed to spending on hospitals and doctors
The reason the facts above matter is because when you walk into a hospital, make an appointment to be seen, or decide to take medications, you become a paying client for the business.
Next, let’s review the truths we must consider before we become a revenue unit for this ballooning multi-trillion dollar business.
Truth #1: The system is NOT on your side
There is an inherited conflict of interest when dealing with the healthcare system.
Let`s review a scenario to learn more.
Let`s say, your daughter, Elena got sick with a cold. She is miserable and her head hurts. Elena misses three days of school and continues feeling bad, so you decide to take her in to be seen by a doctor. When you show up to the office, your goal is to get her better as soon as possible, stop the suffering, receive an affordable medical bill and have no need to come back. Your goal is to get Elena as healthy as soon as possible. Right?
Next, let`s think about how the doctor`s clinic (for-profit business) perceives the same appointment. An appointment is an opportunity to sell you medical services and make money.
The clinic`s goal is to stay profitable by reducing costs, and driving revenue, reduce time with the provider, sell extra services: prescriptions written, additional tests and labs, and assure you come back in the future, so the business can make more money. Your and clinic`s goals are at odds. In fact, they are contradictory.
The healthcare business was created to drive revenue, and there is no money in healthy people, keep that in mind, the healthcare system is not on your side, they are business.
Truth #2: Medical bills can kill you
By now, you may wonder how much can these healthcare services cost? Before I share any facts, I need to make sure you pull over, park, or simply take a seat; this is not the kind of thing you want to take on while standing.
Average costs of medical procedures:
- Assumptions: uninsured patient, out of network provider, location – Northern Colorado, U.S
- Please note your prices will vary by state, provider, and the codes your were billed)
- Nobody in the hospital/urgent care at the time of the service will tell you how much things cost. Medical personnel is not trained to answer your questions not they have access to the information about cost.
- The costs below were sourced from Fair Health Consumer website and The Dime
- Diagnostic colonoscopy (includes anesthesia, dr fee, outpatient hospital) = $ 5,738
- Normal, vaginal delivery in 2013 with anesthesia $15,000-30,000. The final costs will depend on the number of days, complications during delivery, labs, extra services baby will be billed, and other factors, such as # of hours in the nursery
- Comprehensive blood test = $271 out of network / $112 in network
- CT scan of abdomen and pelvis with contrast = $3,600-1,406 in network
- Pregnancy ultrasound (women), first trimester = $560-270
- Hospital stay per 24 hours, no services delivered = $500-700 per room
- Emergency department visit, threat of life/function = $ 4,000 – 2,500 per visit
- Emergency room visit moderately severe problem = $1,800-900
- New patient, office visit, 30 min = $220-120 (not specialist)
- New patient, office visit, 60 min = $530-280
- Mammography, both breasts = $470-250
- Xray, foot, 3 views = $540-270
- One single injection for treatment, meds delivery, etc = $130-50
- Cost of 1 Tylenol pill in a hospital = $10-12 per pill
- The average hospital stay in U.S. in 2020 = $30,594 (Credit: org)
What does this all mean to you? It means your medical bills can kill you! Lets look at a common scenario.
You are going on a hike to the park, and while walking twist your ankle. Two days later, your ankle is swelling up, and you are in a lot of pain, so you decide to stop by urgent care and get the injury checked. The wait is short and you get it quickly. They give you a room and get you into a hospital bed.
Everyone is very nice and the doctor recommends running some tests to check for a fracture. After a little wait, the nurse runs you to Xray and the image reflects that the pain is just an ankle sprain. You are leaving urgent care 3 hours later and almost forget about the event.
Your ankle heals well and you’re moving on with your life. One day, almost 2months after the urgent care visit you receive a $5,700 bill. You may feel confused, cheated, and angry. This happens every day to thousands of patients.
Truth #3: You must be insured
So how can Americans afford to pay their medical bills? Well, they don’t. That is why they have insurance.
One of the things I was wrong about, while first encountered medical and healthcare insurance topic, is I assumed only sick people need to be insured. I figured if I am healthy, why should I pay each month for insurance??? I never go to doctors. Money wasted.. right? Not really. I was wrong!
The truth is medical insurance can cost you big bucks, whether you sign up for your employer healthcare or purchase private insurance coverage plan you need to be ready, it will be costly. For example, our family is has a “lowest deductible” family plan that still wracks up into about $400 per month bill for a family of five, which I was told is pretty cheap. If you have private insurance, that can cost as much as $500-1000 per person, monthly for the same exact coverage.
That said, not having any medical coverage can kill your family finances very quickly. Good insurance plans can cover up to 80-90% of the total medical bill!
Insurance is a risk management mechanism that lowers your chances of the financial crisis; should you need urgent medical attention. No matter what, make sure you and your family members have adequate medical coverage.
Of course, you may think I am over exaggerating, but in reality, one MAJOR health event may destroy or put a significant hole in your family finances. The bill can also ruin your credit history and question your trust in the American Healthcare system since nobody will be able to actually tell you what things cost before you agree to the services.
The post will start a series of posts to uncover the ugly truth behind American Healthcare and take stub brainstorming solutions on how to reduce your risk of becoming a victim of the system.
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